Endoscopic surgical clip

ABSTRACT

A surgical spring clip is provided for use in minimally invasive surgical procedures. The clip has a flat planar plate shape having pair of arms connected by a base, all generally positioned within a single plane. The arms are elongate linear cantilevered beams extending beyond the base and are biased to a first or closed position generally within the plane. The base and arms define a slot for the positioning of and receiving a vessel and occluding the flow therethrough.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. Ser. No. 10/421,151, filedApr. 22, 2003 now U.S. Pat. No. 7,896,896, which claims priority fromand the benefits of U.S. Provisional Application Ser. No. 60/374,623,filed on Apr. 22, 2002, the entire contents of which are herebyincorporated by reference.

BACKGROUND

1. Technical Field

The present disclosure relates to devices and methods for occludingvessels. More particularly, the present disclosure relates to ligatingclips and methods for using ligating clips during surgical procedures.

2. Background of Related Art

During surgical procedures, it is frequently required either to occludevessels temporarily or permanently to prevent the leakage of bloodthrough incisions made at a surgical site. A wide variety of surgicalligating device configurations and techniques exist for accomplishingtemporary and permanent occlusions. These include, for example, tubular,rod, and wire devices typically biased to a closed position. Ligatingclips are configured for application directly by the hand of a surgeon,by remotely operated devices in open surgery, and/or by specializedinstruments for minimally invasive surgical procedures.

Ligating clips used in minimally invasive surgery are frequentlyconstrained in their configuration by their requirement to feed inseries into an instrument configured for remotely applying clips. Therequirement for compatibility with the applying instrument can oftenconstrain the configuration of the clip.

Many ligating clips are formed of ductile material, e.g. metal, whichclips, once applied, are largely unresponsive to changes in vessel wallthickness, for example, due to swelling, inflammation, or shrinkage.Such clips in certain instances may traumatize the vessel wall or notmaintain the desired occlusion force. Thus, a need exists for ligatingspring, or surgical, clips that are more responsive to changes in vesselwall thickness, by the clip allowing for expansion or spreading of theoccluding portions of the clip to accommodate vessel wall swelling orinflammation, or providing further closure of the clip to adjust forvessel wall shrinkage. There is a need for such ligating spring, orsurgical, clips that can adjust to reduce traumatization and/or maintainsufficient occlusion force.

A need also exists for simplified ligating clips with simplified shapesthat can be applied remotely by a hand-held instrument during minimallyinvasive surgical procedures.

SUMMARY

This invention is directed to a spring clip for occluding a vessel andincluding a base and a jaw. The jaw is in a substantially planararrangement with the base and includes elongate first and second armswith front and tail ends. The tail ends of each are in flexiblecommunication with the base to define a longitudinal axis where the armsare moveable in an axis perpendicular to the longitudinal axis. At leastone arm can have a tab adjacent its front end. Alternatively, the frontends of the arms can each include a tab where the tabs overlap. The tabsmay be arcuately shaped. The first arm can be in a substantially planararrangement with the second arm along the longitudinal axis. The firstarm may be spaced apart from the second arm where the arms define a slottherebetween. The front end of the first arm may include a tab that isdisposed orthogonally to the first arm and in front of the second arm.The arms may be substantially equal in length. The first arm can belonger than the second arm. A retention mechanism can be disposedperpendicularly to the longitudinal axis to urge the first and secondarms into a predetermined relationship. Each the arm may also include atleast one socket for receiving a biasing mechanism where the biasingmechanism is capable of moving the arms in opposing directions away fromthe longitudinal axis.

This invention is further directed to a surgical spring clip foroccluding a vessel that includes a rigid base having a back end portionand a jaw. The jaw is in a substantially planar arrangement with thebase and includes first and second elongate arms that are disposed in asubstantially planar arrangement to define a first, closed position ofthe clip. The arms are substantially parallel to each other defining alongitudinal axis and are spaced apart from each other defining a slot.The arms further have front and tail end portions where the front endportions flexibly extend from the base. The front end portion of atleast one of the arms can include a tab. The at least one tab can have aprotrusion that is oriented towards the slot. The at least one tab mayextends beyond a centerline of the slot. The first arm can besubstantially equal in length to the second arm. The first arm can belonger than the second arm and includes a tab oriented to transect animaginary line extending from the centerline of the slot. The tail endsof the first and second arms can communicate with the back end portionof the base.

The presently disclosed endoscopic spring clip, together with attendantadvantages, will be best understood by reference to the followingdetailed description in conjunction with the figures below.

BRIEF DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the presently disclosed endoscopic surgicalclip are described herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of one embodiment of an endoscopic surgicalclip in a first position in accordance with the present disclosure;

FIG. 1A is a vertical sectional view, with portions taken away, as wouldbe seen along line A-A of FIG. 1;

FIG. 2 is a top view of a second embodiment of the endoscopic surgicalclip in a first position in accordance with the present disclosure;

FIG. 3 is a top view of a third embodiment of the endoscopic surgicalclip in a first position in accordance with the present disclosure;

FIG. 4 is a side view of the endoscopic surgical clip of FIG. 1 in asecond position with a vessel generally aligned with the axis-Y andpositioned between the arms;

FIG. 5 is the side view of the endoscopic surgical clip of FIG. 4 intransition from the second position towards the first position with thevessel positioned between the arms and moving relative to the clipbetween the axes Y and Z;

FIG. 6 is an base end view, with portions removed, of the base and armsof endoscopic surgical clip of FIG. 4 in transition from the secondposition towards the first position with the vessel positioned betweenthe arms and in transition relative to the clip between the axes Y andZ; and

FIG. 7 is a base end view, with portions removed, of the base and armsof the endoscopic surgical clip of FIG. 5 approximately in the firstposition with the ligating surgical clip generally aligned with theplane X-Y and the vessel generally aligned with axis-Z.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Referring now in specific detail to the drawings in which likereferenced numerals identify similar or identical elements throughoutthe several views, and initially to FIGS. 1, 4, and 6, a surgical springclip or a ligating clip 10, preferably an endoscopic spring clip,constructed in accordance with the present disclosure, is shown in afirst, closed, position. Ligating clip 10 includes a preferably rigidbase 20 and a jaw 60. Jaw 60 includes a first arm 30 and a second arm40. Ligating clip 10 has an elongate plate-like shape defining alongitudinal axis-X and having a first face 12 and an opposed secondface 14 (not shown) oriented in opposing directions of an axis-Z. Arms30 and 40 are cantilevered elements extending from base 20 and aregenerally parallel with a longitudinal axis-X. An axis-Y intersects andis perpendicular to longitudinal axis-X and arms 30 and 40. Axis-Zintersects with and is perpendicular to axes X and Y.

Base 20 has a back end 22 and a back end portion 24. Base 20 connects oris in flexible communication with arms 30 and 40 and is configured tosupport the flexing of arms 30 and 40 along axis-Z. Alternative back end22 or base 20 configurations include a tube or rod forming an axleparallel with axis-Y connecting two separate arms 30 and 40 together andproviding suitable bias and structural integrity. It is alsocontemplated that the base 20 may be thicker or thinner in dimensionrelative to arms 30 and 40 in the direction of axis-Z.

Arms 30 and 40 each have front end portions or tips 32 and 42respectively and tail ends 34 and 44 connected to base 20. Arm 30 has anouter edge 36 and an inner edge 38. Arm 40 similarly has an outer edge46 and an inner edge 48. Inner edges 38 and 48 of tips 32 and 42preferably have arcuately shaped and inwardly projecting tabs 39 and 49,respectively, generally parallel with axis-Y. Tab 39 of tip 32 and tab49 of tip 42 preferably are at least partially overlapping in thedirection of axis-Z and are configured to be biased by base 20 to thefirst or closed position wherein upper face 12 of tab 39 is in directcontact with lower face 14 (not shown) of tab 49. Tabs 39 and 49function to limit the travel of the adjacent arms and secure clip 10 inthe first position. The configuration of ligation clip 10 accommodateseither tab 49 positioned over tab 39 as shown in FIG. 1, or in thealternative, tab 39 positioned over tab 49. Arms 30, 40 may have auniform thickness in the direction of axis-Z or have a taperedconfiguration such that the thickness in the direction of axis-Z canvary between tail ends 34 and 44, and front end portions or tips 32 and42.

Edges 38 and 48 are shown as having faces generally parallel withaxis-Z. Further still, edges 38 and 48 can include bevels or concaveportions configured to spread the load of arms 30 and 40 over a greaterapplied surface area of a vessel and thereby reduce the trauma to thevessel. A slot 50 is defined by inner edges 38 and 48, tabs 39 and 49,and the edge partly defining base 20. Slot 50 separates, and is definedby, arms 30 and 40 and enables the independent relative movement of arms30 and 40 along axis-Z. The plate-like shape of arms 30, 40 inhibitmovement of arms 30, 40 along axis-Y. Slot 50 is shown in this onepreferred embodiment as an elongate slot generally parallel with thelongitudinal axis-X. Tabs 39 and 39 define a front end of slot 50. Edges38 and 48 defining slot 50 can include undulations, patterns, cut outportions and/or surface finishes to improve the positioning, grip, orretention of ligating clip 10 at a desired point on a vessel 70.Alternatively, edges 38 and 48 can include lubrication positioned on thesurface or embedded within the material of edges 38 and 48.

Arms 30 and 40 flex about the vicinity of the junction of tail ends 34and 44 with base 20 in the general direction of axis-Z from the biased,closed, first position to a second, or open, position. Base 20 providessufficient structural integrity to inhibit the bending of base 20. Inthe first, or closed, position, arms 30 and 40 as well as base 20 aregenerally in alignment with each other and in a plane defined by axesX-Y. This would be equally true if arms 30, 40 did not have overlappingtabs 39, 39. Tips 32 and 42 are biased to be in direct contact and mayextend out from plane X-Y. In the second, or open, position, at leastone of arms 30 and 40 has moved to diverge from plane X-Y in one of thedirections along axis-Z and arms 30 and 40 may have taken on an arcuateor straight configuration. Arms 30 and 40 in the second or open positiondefine a range of channels between axes Y and Z suitable for the passageof vessel 70 therethrough and into, or within, slot 50. Arms 30 and 40are configured to resist and preclude flexing or bending in the generaldirection of axis-Y.

In a preferred embodiment, arms 30 and 40 have a generally rigid orsemi-rigid construction and are configured to resist, for example,torquing forces about axes parallel with axis-X and forces generallyaligned with axis-Y. In the alternative, arms 30 and 40 can have aconstruction such that arms 30 and 40 can flex at multiple or infinitepoints about axes parallel to axis Y and still retain sufficientrigidity and strength in the general directions of axis-Y to constrict avessel positioned within slot 50. Arms 30 and 40 can be sufficientlyrigid such that tabs 39 and 49 directly intersect and block the passageof arms 30 and 40 past one another in the opposing directions of axis-Z.In the alternative, arms 30 and 40 can have sufficient flexibility toaccommodate the rotation of arms 30 and 40 and/or flexing of tabs 39 and49 sufficiently for arms 30 and 40 to pass by one another in thedirection of axis-Z when external forces are applied in the direction ofaxis-Z.

Ligating clip 10 in any embodiment can include a retention mechanism 90(shown in FIG. 1 in dashed lines) disposed perpendicularly to axis-X andconfigured to urge arms 30, 40 and position tips 32 and 42 in a securepredetermined relationship. Retention mechanism 90 can include knownmechanical banding mechanisms, such as an elastic strap configured foraccommodating the opposing tab 39 or 49, as well as a band configured toapply a bias along axes Y and/or Z to retain tabs 39 and 49 together.Tabs 39 and 49 can include interlocking edges with mating orinterlocking cutouts to assist in retaining arms 30 and 40 in the firstposition. Further, slot 50 can be configured to define multiplestair-stepped channels and interlocking positions to accommodate two ormore cross-sectional sizes of vessels within the length of slot 50 byvarying the distances between edges 38 and 48. By varying the width ofthe slot 50 in the direction of the axis-Y, the amount of pressureapplied to a given vessel can be selectively controlled.

Ligating clips 10 can also include mechanical assistance devices orfeatures to assist in biasing or spreading arms 30, 40 to facilitate theapplication of ligating clips 10 to vessels 70 during minimally invasivesurgery. For example, a pair of sockets 80 extending in directions alongaxis-Z can be provided in upper face 12 and lower face 14, to receiveelongated members, e.g. pins that would facilitate opening arms 30, 40.Alternatively, a pair of sockets 80 could be defined as holes, and couldbe disposed, for example, parallel to axis-X through back end 22 of base20 and extending distally at least partially within arms 30 and 40.Sockets 80 could also be at least one slot formed, for example, in edges36 and 46 for the manipulation of arms 30 and 40 in opposite directionsfrom axis-X, respectively. Thus, sockets 80 can provide an additionalmethod for remotely spreading arms 30 and 40 in opposing directions ofaxis-Z for the positioning of a vessel during endoscopic or minimallyinvasive surgery.

Ligating clip 10 can be fabricated of a suitable medical grade metal,composite, or plastic material providing a flexing or spring typepivotal movement and a bias to arms 30 and 40 as well as sufficientrigidity for securely clipping a vessel in the first position. Ligatingclip 10 can have a uniform composition, different base and armmaterials, or have a laminated structure of varying composition.

Referring now to FIG. 2, ligating clip 110 in a second preferredembodiment has a base 120, first arm 130, and second arm 140. Ligatingclip 110 has a flat planar construction aligned with a plane defined bythe intersection of orthogonal longitudinal axis-X and axis-Y. First arm130 has a greater length along axis-X than second arm 140. Arm 130 has atip 132 having a tab 139 with a 90° or right angle bend extendingperpendicular to axis-X and in the direction of axis-Y until it isapproximately in front of and aligned with an outer edge 146. Arm 140has a straight elongate shape terminating in a tip 142. An open-endedslot 50 is defined by base 120, arm 130, and arm 140. Slot 50 extendsalong axis-X from base 120 and makes a right angle bend between tip 142and tab 139.

FIG. 3 shows a third embodiment of a ligating clip, generally designated210, having a base 220, first arm 230, and second arm 240. Ligating clip210 has a flat planar construction aligned with a plane defined by theintersection of orthogonal longitudinal axis-X and axis-Y. First arm 230and second arm 240 have an approximately equal length along axis-X andinclude tips 232 and 342 having inwardly projecting tabs 239 and 249.Tabs 239 and 249 have an opposing orientation and are parallel withaxis-Y. A slot 250, aligned with longitudinal axis-X, is defined byinside edges 238 and 248. Edge 238 of tab 239 and edge 248 of tab 249can be configured to be adjacent to each other, as shown, and definingan opened ended slot 250, or in direct contact, terminating slot 250.Tabs 239 and 249 may be configured to provide a mating interface such asa tongue and groove for forming a friction based connection at tips 232and 242.

In operation, spring or flexible ligating clips 10, 110, and 210 (forsimplicity, hereinafter, 10) are preferably applied during minimallyinvasive surgical procedures. Ligating clip 10 has a first position, asshown in FIG. 1, with tabs 39 and 49 of tips 32 and 42, respectively,being in an overlapped position. Arms 30 and 40 are preferably biased tothe first, or closed, position and generally positioned within the planedefined by axes X and Y.

Ligating clip 10 in the second position, as shown in FIGS. 4 and 6, hasarms 30 and 40 flexing in opposing directions along axis-Z as a resultof a force or forces effectively applied in the general direction ofaxis-Z. Arms 30 and 40, separated along axis-Z in a second, or open,position create a range of channels between axis-Y and axis-Z. Jaw 60 isin an open or spread position against the bias of forces-B as applied bybase 20 on arms 30 and 40 urging jaws 60 to the first position.

Referring now to FIGS. 4-7, ligating clip 10 is shown in this onepreferred embodiment having vessel 70 initially positioned inapproximate alignment with axis-Y between arms 30 and 40 in the secondposition. Upon the removal of forces-A, the bias in ligating clip 10 isshown as forces-B in the opposing direction of axis-Z, drives arms 30and 40 to return to the first position. Ligating clip 10 is shown insteps returning to the first position from the second position as therelative positional relationship between vessel 70 and ligating clip 10(FIG. 4) transitions from the vessel being approximately aligned withaxis-Y to being approximately aligned with axis-Z (FIG. 7). The scissortype action of arms 30 and 40 in the first position securely constricts,or occludes, vessel 70 from fluid communication. Depending on thecircumstances, ligating clip 10 can be left permanently in position orsubsequently removed if it is temporarily applied.

Although it is envisioned that the width of slots 50, 150, or 250 ofligating clips 10, 110, or 210 theoretically can be the same or lessthan the same dimensions as the total thickness of the particularvessel(s) to be occluded, the actual width(s) of slots 50, 150, or 250will depend upon various factors, including the thickness and conditionof the vessels to be occluded, and can be determined from experimentaldata that will render the desired dimension apparent to those skilled inthe art.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, it isto be understood that the disclosure is not limited to those preciseembodiments, and that various other changes and modifications may beaffected therein by one skilled in the art without departing from thescope or spirit of the disclosure. All such changes and modificationsare intended to be included within the scope of the disclosure.

1. A surgical spring clip for occluding a vessel, comprising: a rigidsubstantially planar base; a jaw in a substantially planar arrangementwith the base and including first and second elongate arms, the firstand second arms being disposed in a substantially coplanar arrangementin a first, closed position of the clip, the arms being substantiallyparallel to and spaced apart from each other, the arms defining alongitudinal plane extending therebetween and defining a slot having awidth less than a width of either the first or second arms, the armsfurther having front and tail ends, the front ends flexibly extendingperpendicular from the base from the first closed position to avertically spaced apart second position; and a tab disposed on the frontend of each of the first and second elongate arms wherein at least aportion of each of the tabs extends through a longitudinal planebisecting the slot and are in contact with each other when the frontends are in the first, closed position and at least a portion of eachtab extends through the longitudinal plane bisecting the slot and arevertically spaced apart and at least a portion of each tab extendsthrough the longitudinal plane bisecting the slot when the front endsare in the second position.
 2. The clip of claim 1, wherein at least oneof the tabs forms a distal end of the slot.
 3. The clip of claim 1,wherein at least one tab is oriented towards the slot.
 4. The clip ofclaim 3, wherein the at least one tab extends beyond a centerline of theslot.
 5. The clip of claim 1, wherein the first arm is substantiallyequal in length to the second arm.
 6. The clip of claim 4, wherein thefirst arm is longer than the second arm and includes a tab oriented totransect an imaginary line extending from the centerline of the slot. 7.The clip of claim 1, wherein a bottom face of the tab disposed on thefirst elongate arm is in contact with a top face of the tab disposed onthe second elongate arm.
 8. The clip of claim 1, wherein the tabs arevertically positioned along a vertical axis in both the first and secondpositions.
 9. The clip of claim 1, wherein each tab extends beyond acenterline of the slot.
 10. A surgical spring clip for occluding avessel, comprising: a rigid planar base; a jaw including first andsecond elongate arms, the arms being substantially parallel to eachother in a substantially planar arrangement, wherein the arms are spacedapart from each other and define an elongated slot therebetween, theslot having a width less than a width of either the first or secondarms; and a pair of tabs disposed on the front end of each of the firstand second elongate arms, wherein at least a portion of each of the tabsextends beyond the width of the slot when the arms are in a first,closed position and when the arms are in a second open, verticallyspaced apart, position for the reception of a vessel therebetween. 11.The clip of claim 10, wherein a bottom face of the tab disposed on thefirst elongate arm is in contact with a top face of the tab disposed onthe second elongate arm.
 12. The clip of claim 10, wherein the tab isvertically positioned along a vertical axis in both the first and secondpositions.
 13. A surgical spring clip for occluding a vessel,comprising: a rigid planar base; a jaw including first and secondelongate arms, the arms being substantially parallel to each other in asubstantially planar arrangement, wherein the first arm is substantiallyequal in length to the second arm and the arms are spaced apart fromeach other to define an elongated slot therebetween, the slot having awidth less than a width of either the first or second arms; and a tabdisposed on the front end of at least one of the first and secondelongate arms wherein at least a portion of the tab extends beyond thewidth of the slot when the arms are in a first, closed position and whenthe arms are in a second open, vertically spaced apart, position for thereception of a vessel therebetween.
 14. The clip of claim 13, whereinthe tab is vertically positioned along a vertical axis in both the firstand second positions.